The neuronal biomarker NSE correlates with the volume of lung contusion in polytraumatized patients.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2024-09-03 DOI:10.1097/SHK.0000000000002475

Anna Carola Rix, Philipp Störmann, Jan Tilmann Vollrath, Jason-Alexander Hörauf, Kathrin Eichler, Ingo Marzi, Cora Rebecca Schindler

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引用次数: 0

Abstract

Background: Severe injuries caused by accidents, like traumatic brain injury (TBI) or thoracic trauma (TT) continue to be the leading cause of death in younger people with relevant socio-economic impact. Fast and targeted diagnostics is essential for further therapy decisions and prognosis. The following study investigates NSE as a potential biomarker for lung injury after blunt TT.

Methods: This is a retrospective analysis of prospectively collected data in a level-1 trauma center from 2014 to 2020. Serum levels of Neuron-specific Enolase (NSE) and Interleukins (IL-6, IL-10) in injured patients (n = 41) with isolated TT (AISthorax ≥ 3) compared to isolated TBI (AIShead ≥ 3) were assessed from day 0 to 5 after trauma. The extend of lung injury was quantified by Hounsfield scale in CT scans.

Results: 30 patients with TT (ISSmed = 20, age 50y ± 17, 83,3% male) and 11 patients with TBI (ISSmed = 25, age 54y ± 17,27,3% male) were included. After TT, NSE concentration increased initially after trauma with a peak value on the day of admission (8.51 ± 3.68 ng/ml) compared to healthy controls (4.51 ± 1.504 ng/ml, p < 0.001). Isolated thoracic trauma and TBI lead to equally strong NSE release ad the day of admission. There is a significant linear relationship (r = 0.636, p = 0.035) between serum NSE levels and severity of pulmonary contusion at the time of admission and after 24 hours.

Conclusion: A significant NSE release after isolated thoracic trauma peaks on the day of admission. The extent of lung contusion volume (defined as alveolar parenchymal density) correlates with NSE serum concentration. Thus, NSE has predictive value for the extent of pulmonary contusion. However, according to these data, NSE seems to have no diagnostic value as a TBI biomarker in concomitant TT.

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神经元生物标志物 NSE 与多发性创伤患者的肺挫伤体积相关。

背景：事故造成的严重伤害，如创伤性脑损伤（TBI）或胸部创伤（TT），仍然是年轻人死亡的主要原因，并对社会经济产生相关影响。快速和有针对性的诊断对于进一步的治疗决策和预后判断至关重要。以下研究将 NSE 作为钝性创伤后肺损伤的潜在生物标志物进行调查：这是对一家一级创伤中心从 2014 年至 2020 年收集的前瞻性数据进行的回顾性分析。从创伤后第0天到第5天，评估了孤立性TT（AIS胸廓≥3）与孤立性TBI（AIS头部≥3）伤员（n = 41）血清中神经元特异性烯醇化酶（NSE）和白细胞介素（IL-6、IL-10）的水平。肺损伤范围通过 CT 扫描中的 Hounsfield 标度进行量化：结果：共纳入 30 名 TT 患者（ISSmed = 20，年龄 50y ± 17，83.3% 为男性）和 11 名 TBI 患者（ISSmed = 25，年龄 54y ± 17，27.3% 为男性）。与健康对照组（4.51 ± 1.504 ng/ml，P < 0.001）相比，创伤后 NSE 浓度在入院当天达到峰值（8.51 ± 3.68 ng/ml）。入院当天，孤立的胸部创伤和创伤性脑损伤会导致同样强烈的 NSE 释放。入院时和 24 小时后，血清 NSE 水平与肺挫伤严重程度之间存在明显的线性关系（r = 0.636，p = 0.035）：结论：孤立性胸部创伤后的 NSE 释放量在入院当天达到峰值。肺挫伤面积（定义为肺泡实质密度）与 NSE 血清浓度相关。因此，NSE 对肺挫伤程度具有预测价值。然而，根据这些数据，NSE 作为 TBI 生物标记物似乎对同时发生 TT 的患者没有诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.